W & T Mushroom Ltd.

R.R. #2 Rockwood, Ontario N0B 2K0
Tel (519) 856 - 4874
Fax (519) 856 - 4373

"Our business is mushrooming"

www.WTMushroom.com - Customer Order Form
For new customers or any questions send email to wt.mushroom@gmail.com
NETSCAPE users: if you can't send the form click here

( * Required Information)

Company Name:*
Contact Name:*
Street Address:*
City: *
State/Prov:*
Postal:*
Phone:*	Ext:
Fax Number:
E-mail:
Mushrooms:	Specify how many boxes
	Shiitake Medium (box - 3 lbs) boxes Shiitake Premium (3 lbs) boxes Oyster (2 lbs) boxes King Oyster (3 lbs) boxes Portabella (5 lbs) boxes Portabellini (2.5 lbs) boxes Enoki (100 gram) vacuum pack White (5 lbs) Select #1 Buttons Utilities #2 Crimini (5 lbs)
Mushrooms:	Specify how many pounds
(per pound)	Black Trompette lbs Boletus lbs Chanterelle lbs Chanterelle Blue lbs Lobster lbs Matsutake #1 lbs #2 lbs #3 lbs #4 lbs #5 lbs #6 lbs Morels lbs Cauliflower lbs Hedgehog lbs Yellow Foot lbs Cloud-ear lbs Chiken of the woods lbs Truffles Black lbs Truffles White lbs
Please specify if other:
Delivery:
When Required:*
Additional Comments:

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You will be contacted within 24 hours of submitting this form.